Abstract
Translational medicine efforts, geared towards the development of new drugs, have brought numerous biologicals from the bedside of rheumatoid and juvenile idiopathic arthritis patients to bench. Biologicals took the attention of the pharmaceutical industry, as well as rheumatologists, away from the first drug that advanced the treatment of rheumatic diseases – methotrexate (MTX). As a consequence, crucial unmet needs surrounding MTX still remain poorly elucidated, even though this anchor drug is taken by many more patients than biologicals and its efficacy has not consistently been surpassed by biologicals in MTX-naive patients. These unmet needs include an incomplete understanding of anti-inflammatory actions of MTX and the inability to predict MTX response. Addressing these needs will result not only in optimization of MTX use, but also of biological use, leading to personalized tailor-made therapy. This review will discuss the place of MTX in juvenile idiopathic arthritis, illustrated by examples from ...
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